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ANESTHESIA FOR TONSILLECTOMY IN CHILDREN:  ENDOTRACHEAL TECHNIQUE, WITH CARDIOVASCULAR OBSERVATIONS

Vincent J. Collins, M.D.; Alfred Granatelli, M.D.
JAMA. 1956;161(1):5-9. doi:10.1001/jama.1956.02970010007002.
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• Psychological preparation of a child includes a preoperative visit from the anesthesiologist, who must gain the child's confidence and must explain the program of the following day.

The premedication for anesthesia here recommended is scopolamine given intramuscularly and 50 to 150 mg. of secobarbital given rectally. The subsequent anesthetic inductions, in the 50 cases here reported, were all carried out with a vinyl ether-diethyl ether sequence by the open drop technique. Thereafter the anesthesia was maintained with an ether-oxygen mixture. It was given after endotracheal intubation by the orotracheal route under direct laryngoscopy in 25 patients; in the remaining 25 patients it was given by using the ether hook for insufflation.

A comparison of the two groups revealed some disadvantage in both methods, but the advantages of the endotracheal technique far outweigh any disadvantages. It is recommended as causing less asphyxial phenomena, giving better control of respiration, affording better working conditions for the surgeon, and minimizing the trouble caused by bleeding and secretions.

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